Provider Demographics
NPI:1538874045
Name:GOLD, YACHAT MALKA (RDN)
Entity type:Individual
Prefix:
First Name:YACHAT
Middle Name:MALKA
Last Name:GOLD
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 ROCKEFELLER DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4340
Mailing Address - Country:US
Mailing Address - Phone:845-517-8576
Mailing Address - Fax:
Practice Address - Street 1:47 ROCKEFELLER DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4340
Practice Address - Country:US
Practice Address - Phone:845-517-8576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered